This document presents a case study of a 34-year-old female school teacher diagnosed with catamenial pneumothorax. She experiences chest pain and shortness of breath every 30-40 days associated with menstruation. Her history reveals similar recurring symptoms for the past 4 years. Catamenial pneumothorax is defined as recurrent pneumothorax occurring in relation to the menstrual cycle. It involves right-sided pneumothorax in most cases and is associated with diaphragmatic perforations and thoracic endometriosis syndrome. Treatment involves hormonal therapy using GnRH analogues as well as video-assisted thoracoscopic surgery for pleurodesis or repair of diaphragmatic defects.
Imaging plays an important role in diagnosis and formulating differential diagnosis in case of Solitary pulmonary nodule. It helps in differentiating and predicting benign and malignant nodules.
Imaging plays an important role in diagnosis and formulating differential diagnosis in case of Solitary pulmonary nodule. It helps in differentiating and predicting benign and malignant nodules.
Respiratory Disorders
Disease Condition Pneumothorax, Causes, Sign and Symptoms, Pathophysiology, Types, Assessment and Dignostic Test, Management
By HIREN GEHLOTH For Nursing Students Medical Surgical Nursing
LAUGH A LOT IT CLEARS THE LUNGS
TEACHING IS ONE PROFESSION THAT CREATE ALL OTHER PROFESSION
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
3. Presenting Complaints:
1. Sudden onset of chest pain on the left side for 2 days.
2. Shortness of breath for 2 days.
3. Dry cough for 2 days.
No history of fever, hemoptysis, hematemesis or trauma.
4. Past History
She has history of episodes of similar symptoms at every
30-40 days duration for last 4 years.
The SOB & chest pain were always followed by menstruation.
5. Personal History
Married for last 10 years
No history of pregnancy: G0P0
No children
Menstrual History
Irregular cycle (30-40 days) with dysmenorrhea
Associated with chest pain, SOB and backache
7. Pneumothorax
Accumulation of air in the pleural space
Pathophysiology: Disruption of visceral pleura
Trauma to parietal pleura
• Pleuritic pain, dyspnea (in 80-90%)
9. Spontaneous Pneumothorax
Primary spontaneous (80%)
Cause:
rupture of subpleural blebs
Age: 20-40 years;
M:F = 8:1
Young tall stature men
Mostly in smokers
Secondary spontaneous (20%)
Air-trapping disease
Pulmonary infections
Granulomatous disease
Malignancy
Connective tissue disorder
Pneumoconiosis
Vascular disease
Catamenial
[Greek: kata , = according to; men= month]
10. Types of Pneumothorax
Open : chest wound
air move in & out of pleural space during respiration
Closed : intact thoracic cage
no air movement
Valvular: enter during inspiration & doesn't exit
Tension : (clinical diagnosis)
higher in barotrauma
13. Catamenial Pneumothorax (CP)
CP is defined as recurrent pneumothorax (at least two episodes)
occurring between the day before and within 72 hours after the
onset of menstruation.
14. Epidemiology:
Incidence of 3-6 % among all the pneumothoraxes in women.
Involves right-side (85-95%) or can be left-sided or bilateral.
Associated with diaphragmatic perforations and/or thoracic
endometriosis syndrome.
15. TES is the presence of endometrial tissue in or around
the lung & consists of 4 distinct clinical entities:
1. Catamenial pneumothorax (CP),
2. Catamenial hemothorax,
3. Hemoptysis &
4. Pulmonary nodules or implants.
Thoracic endometriosis syndrome (TES)
16. Why right?
Physiologically, peritoneal fluid moves in a clockwise
fashion from the pelvis along the right paracolic
gutter to the subphrenic space.
Endometrial tissue located within the peritoneum
likely follows the same directional flow, landing more
commonly on the right hemi diaphragm.
Once there, the falciform ligament prevents further
travel of tissue to the left.
17. Theories for CP
Ingression of air via diaphragmatic fenestrations
from the vagina to the peritoneum
Hormonal: Rupture of pre-existing pleural blebs/
alveoli during menstruation by increase in PG-F2.
Sloughing of Pleural or parenchymal endometrial
implants in the lung.
18. Diagnosis:
1. X-ray chest PA view
2. CT scan of Chest
3. Hormone level of gonadotropin hormones
4. Video-Assisted Thoracoscopic Surgery (VATS)
19. Chest radiograph
Visceral pleural edge seen as a very thin, sharp white line
No lung markings are seen peripheral to this line
Peripheral space is radiolucent compared to adjacent lung
The lung may completely collapse
Mediastinum shift (+)– if tension pneumothorax is present
Expiratory chest radiograph
20. CT
Identifies even small pneumothoraces not visible in CXR
Differentiates bullous disease from intrapleural air
CT guided drain in complicated or inaccessible pneumothorax:
Posterior location or tethered lung
24. Treatment: Pneumothorax
Asymptomatic small rim pneumothorax (<2 cm): no treatment with
follow up radiology to confirm resolution
Pneumothorax with mild symptoms (no underlying lung condition):
needle aspiration in the first instance
pneumothorax in a patient with background chronic lung disease or
significant symptoms: intercostal drain insertion (small drain using the
Seldinger technique)
25. TREATMENT: CP
Medical :
Hormonal therapy (GnRH analogue)
Surgical: VATS
Pleurodesis
Repair of diaphragmatic defects with an artificial mesh
Treatment are usually medical in conjunct to surgical alleviation of the
disease.
For these symptoms she was treated by gynecologists on the basis of dysmenorrhea or menorrhagia for last 4 years.
Respiratory system: There was a restricted chest wall movement on the left side. Vocal fremitus absent on the left side
fallen lung sign = hilum of lung below expected level within chest cavity
Cause: rupture of subpleural blebs in apical region of lung
(a) Air-trapping disease: spasmodic asthma, diffuse emphysema, Langerhans cell histiocytosis, lymphangiomyomatosis, tuberous sclerosis, cystic fibrosis,
Chronic obstructive pulmonary disease is the most common predisposing disorder of secondary spontaneous pneumothorax
(b) Pulmonary infections: lung abscess, necrotizing pneumonia, hydatid disease, pertussis, acute bacterial pneumonia, S. aureus, Pneumocystis carinii pneumonia
(c) Granulomatous disease: tuberculosis, coccidioidomycosis, sarcoidosis, berylliosis
(d) Malignancy: primary lung cancer, lung metastases esp. osteosarcoma, pancreas, adrenal, Wilms tumor
(e) Connective tissue disorder: scleroderma, rheumatoid disease, Marfan syndrome, EhlersDanlos syndrome
(f) Pneumoconiosis: silicosis, berylliosis
(g) Vascular disease: pulmonary infarction
Pathophysiology: intrapleural pressure exceeds atm. pressure in lung during expiration (check-valve mechanism)
When collection of gas is constantly enlarging, resulting compression of mediastinal structures it can be life-threatening and is known as a tension pneumothorax.
Tension hydropneumothorax: air-fluid level in pleural space on erect CXR
Additionally, respiration causes the right hemi diaphragm to contract against the liver, known as the “piston effect,” which potentially allows for endometrial implantation and/or migration across the diaphragm.
Left sided implants: direct seeding of endometrial tissue along with venous drainage.
Finally, although congenital diaphragmatic hernias are far more common on the left side, congenital diaphragmatic defects, particularly fenestrations, are known to occur more commonly on the right, leading to the right-sided predominance of TES
Hormonal : high levels of prostaglandin from thoracic endometrial implants cause vascular and bronchiolar vasoconstriction, leading to ischemic injury and ultimately causing alveolar rupture
lung becomes smaller and volume of pleural air is unchanged .. Hence more conspicuous
normal lung ---interface with pleura shows lung sliding with vertical comet tails running down from the pleural surface.
In pneumothorax, this sliding is absent and so are the comet tail artifacts from the pleura.
This is due to air in between the parietal and visceral pleura, preventing lung from sliding.
Visualising the junction between sliding lung and absent sliding is known as the lung point sign and is near 100% specific for pneumothorax
Not found in all pneumothorax cases (sensitivity is around 65%) especially large pneumothoraces where the lung is collapsed and there is globally absent sliding.
Most catamenial pneumothoraces are small and self resolving. Partial diaphragmatic resection and/or exeresis of visceral pleural implants, as well as talc pleurodesis,